5 research outputs found
Locating sex-specific evidence on clinical questions in MEDLINE: a search filter for use on OvidSPâ„¢
<p>Abstract</p> <p>Background</p> <p>Many recently published clinical studies report sex-specific data. This information may help to improve clinical decision-making for both sexes, but it is not easily accessible in MEDLINE. The aim of this project was to develop and validate a search filter that would facilitate the retrieval of studies reporting high quality sex-specific data on clinical questions.</p> <p>Methods</p> <p>A filter was developed by screening titles, abstracts and Medical Subject Headings (MeSH) in a set of 80 high quality and relevant papers, 75 of which were identified through a review of clinical guidelines and five through other means. The filter, for use on OvidSPâ„¢, consists of nine command lines for searching free text words in the title, abstract and MeSH of a paper. It was able to identify 74/80 (92.5%) of the articles from which it was derived. The filter was evaluated in a set of 622 recently published original studies on Alzheimer's disease and on asthma. It was validated against a reference of 98 studies from this set, which provided high quality, clinically relevant, sex-specific evidence. Recall and precision were used as performance measures.</p> <p>Results</p> <p>The filter demonstrated 81/98 (83%) recall and 81/125 (65%) precision in retrieving relevant articles on Alzheimer's disease and on asthma. In comparison, only 30/98 (31%) recall would have been achieved if sex-specific MeSH terms only had been used.</p> <p>Conclusion</p> <p>This sex-specific search filter performs well in retrieving relevant papers, while its precision rate is good. It performs better than a search with sex-specific MeSH. The filter can be useful to anyone seeking sex-specific clinical evidence (e.g., guideline organizations, researchers, medical educators, clinicians).</p
Harmony in Drug Regulation, but Who's Calling the Tune? An Examination of Regulatory Harmonization in Health Canada
The 'Choice and Autonomy Framework' : implications for occupational therapy practice
Introduction
This paper presents findings from a PhD study exploring
autonomy of adults with physical disability. The plethora
of descriptions of autonomy in psychological, occupational
therapy and rehabilitation literature (e.g. Ryan and Deci 2000,
Rogers 1982, Cardol et al 2002) detracts from the centrality
of autonomy and results in difficulty incorporating it into
occupational therapy practice. This paper presents a framework
providing an integrated, clinically useful approach to autonomy.
Methods
Sixteen people were recruited, based on age, gender,
impairment and living circumstances (community/residential
settings). All have significant physical disability, use a wheelchair
and require personal assistance for some/all self-care activities.
Qualitative methods were used for data collection, including
life-history narrative, diary information and extensive interview.
An integrated method of analysis was used, including content
analysis and bracketing.
Results
The ‘Choice and Autonomy Framework’ consists of five strands,
including:
• the meaning of autonomy
• whether or not autonomy is a goal or value
• the experience of autonomy
• personality factors that impact autonomy
• environmental features that enhance or negate autonomy.
This paper will describe each strand, as derived from the
research. The results suggest that, contrary to common wisdom (Hmel and Pincus 2002), autonomy is not necessarily a universal
goal for people with physical disability; an understanding of the
person’s own perspective will enhance person-centred practice
and enable therapists to further recognise individuality of clients.
It will argue that the concept of autonomy needs to be further
understood and incorporated into occupational therapy practice